Sir,
This is in reference to article “An audit of histopathology reports of carcinoma endometrium: Experience from a tertiary referral center” published in J Postgrad Med 2015;61:84-7. The authors deserve appreciation for their effort.[1]
I would like to mention a few points here in concern to the methodology used for the purpose of this study, even though, I am not suggesting there is anything wrong with the same. This is for the information of readers of this journal in context to this article.
Generally speaking, audit is a systematic and independent examination of data, statements, records, operations and performances (financial or otherwise) for a stated purpose. In an audit, the auditor perceives and recognizes the propositions before him/her for examination, collects evidence, evaluates the same and on this basis formulates his/her judgment which is communicated through his/her audit report. This is the general premise on which an audit is based. Audits in past, conducted on histopathology specimen have followed more or less the same principles.[2,3]
Further, a report published in J Clin Pathology[3] has also reflected on audit reports[4,5] which have been based more on descriptive reporting, as has been used by the authors of this study.[1] This report concluded that a pure descriptive procedure was inefficient and of limited educational value. This is also evident from the conclusion drawn by the authors. The authors conclude that the compliance to adhere to and to provide minimum data information in carcinoma endometrium reports is generally “good”. However, this “good” is not measurable. The non-measurable nature of the audit reports poses problems. There can be problems in agreeing on criteria for a satisfactory or good report. Further scoring based on this satisfactory/good report will suffer in being subjective and arbitrary. Therefore there will always be a lack of confidence in the data. This lack of confidence in the data means that there is no mechanism to close the audit cycle. As a result of these experiences departments have developed a method of examining reports to provide a quantitative assessment of their content.
Given the resources and experience at hand, I am sure the authors may have evolved a methodologically correct way of making audit assessments and we will get to read more of that in future.
References
- 1.Deodhar KK, Rekhi B, Menon S, Ganesh B. An audit of histopathology reports of carcinoma endometrium: Experience from a tertiary referral center. J Postgrad Med. 2015;61:84–7. doi: 10.4103/0022-3859.150444. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Appleton MA, Douglas-Jones AG, Morgan JM. Evidence of effectiveness of clinical audit in improving histopathology reporting standards of mastectomy specimens. J Clin Pathol. 1998;51:30–3. doi: 10.1136/jcp.51.1.30. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Campbell F, Griffiths DF. Quantitative audit of the content of histopathology reports. J Clin Pathol. 1994;47:360–1. doi: 10.1136/jcp.47.4.360. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Ramsay AD, Gallagher PJ. Local audit of surgical pathology. 18 month's experience of peer review-based quality assessment in an English teaching hospital. Am J Surg Pathol. 1992;16:476–82. [PubMed] [Google Scholar]
- 5.Zuk JA, Kenyon WE, Myskow MW. Audit in histopathology: Description of an internal quality assessment scheme with analysis of preliminary results. J Clin Pathol. 1991;44:10–6. doi: 10.1136/jcp.44.1.10. [DOI] [PMC free article] [PubMed] [Google Scholar]
